Management of severe femoral bone loss in revision total hip arthroplasty

Orthop Clin North Am. 2015 Jul;46(3):329-42, ix. doi: 10.1016/j.ocl.2015.02.002. Epub 2015 Apr 11.

Abstract

Femoral bone loss is a complex problem in revision total hip arthroplasty. The Paprosky classification is used when determining the degree and location of bone loss. Meticulous operative planning is essential where severe bone loss is a concern. One must correctly identify the bone loss pattern, safely remove the existing components, and proceed with the proper reconstruction technique based on the pattern of bone loss. This article discusses the etiology and classification of bone loss, clinical and radiographic evaluation, components of effective preoperative planning, and clinical results of various treatment options with a focus on more severe bone loss patterns.

Keywords: Preoperative planning; Reconstruction; Revision total hip arthroplasty; Severe femoral bone loss.

Publication types

  • Review

MeSH terms

  • Absorptiometry, Photon / methods
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / adverse effects*
  • Arthroplasty, Replacement, Hip / methods
  • Female
  • Femur / diagnostic imaging*
  • Femur / surgery
  • Follow-Up Studies
  • Humans
  • Intraoperative Care / methods
  • Male
  • Osteoarthritis, Hip / diagnosis
  • Osteoarthritis, Hip / surgery*
  • Osteoporosis / complications*
  • Osteoporosis / diagnosis
  • Postoperative Complications / prevention & control
  • Prosthesis Failure*
  • Reoperation / methods
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Treatment Outcome